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REGIONAL ANESTHESIA AND PAIN MEDICINE

The Effects of Lactated Ringer’s Solution Infusion on Cardiac Output Changes After Spinal Anesthesia

Mirt Kamenik, MSc, MD^*, and Vesna Paver-Eren, PhD, MD

*Department of Anesthesiology, Intensive Care, and Pain Management, Maribor Teaching Hospital, Maribor, Slovenia; and Clinical Department of Anesthesiology and Intensive Therapy, University Medical Center of Ljubljana, Ljubljana, Slovenia

Address correspondence and reprint requests to Mirt Kamenik, MD, Department of Anesthesiology, Intensive Care, and Pain Management, Maribor Teaching Hospital, Ljubljanska 5, 2000 Maribor, Slovenia. Address e-mail to mirt.kamenik{at}mf.uni-lj.si

We evaluated the effects of an infusion of lactated Ringer’s (LR) solution on changes in cardiac output (CO) after spinal anesthesia. Seventy-five patients scheduled for lower extremity surgery under spinal anesthesia were studied. We measured CO (impedance cardiography method) and blood pressure for 25 min before and 30 min after spinal anesthesia. Patients were randomly assigned to three groups. In the No Infusion group, no LR solution was given during the period of measurements. The LR Before group received 12 mL/kg of LR solution within 20 min before spinal anesthesia. The LR After group received 12 mL/kg of LR solution within 20 min starting immediately after spinal anesthesia. After spinal anesthesia, CO decreased by 13.9% in the No Infusion group. In the LR Before group, CO increased after the infusion by 20% and returned to baseline value 30 min after spinal anesthesia. In the LR After group, CO increased after spinal anesthesia, and 30 min after spinal anesthesia, CO was 11.3% above baseline. We conclude that the decrease in CO after spinal anesthesia can be prevented by the infusion of an LR solution, with CO reaching the highest value while the infusion is running.

Implications: We studied the effects of lactated Ringer’s solution infusion on cardiac output changes after spinal anesthesia. If the patients received no infusion, cardiac output decreased after spinal anesthesia. However, if the patients received lactated Ringer’s solution infusion, cardiac output was maintained.

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